According to the Centers for Medicare & Medicaid Services (CMS), in 2012 on any day, more than 1.4 million Americans live in 15,800 nursing homes; more than 3 million have used nursing home services some time during the year.

You may not be able to control an explosion, earthquake, hurricane, power outage, terrorist attack or other catastrophic natural or human-created events. But, you can make sure you know what will happen to your parent or someone else dear to you should there be one.

Some past disaster plans have been . . . a disaster. In 2005, 70 nursing home residents lost their lives when Hurricane Katrina and Rita barreled through New Orleans and the Gulf Coast area. The federal government’s General Accountability Office (GAO), the independent investigative arm of the U.S. Congress, studied why there were so many lives lost and has brought awareness for the need for more stringent policies.

In 2006, Louisiana passed a law requiring its nursing homes to have a more detailed evacuation plan. It calls for updating their evacuation and disaster preparedness plan once a year and having state officials sign off on their transportation plans.

Last fall, Superstorm Sandy also posed evacuation difficulties in the New York City area. Because of these continuing disasters, the federal government’s CMS, which helps improve nursing home care, expects to issue new disaster planning requirements some time this year.

In some circumstances, residents cannot be evacuated immediately and are ordered to stay where they are (“shelter in place“). There must be plans for this as well.

In the meantime, here are nine questions to ask nursing home administrators:

What is your evacuation plan and does it comply with government standards? Who decides to activate that plan? When was the plan last updated? Do first responders know what the plan says?

What’s the transportation plan in an emergency? How will you get residents out (special equipment?) if the elevators aren’t working?

How often does staff review these plans? When was the facility’s last drill? Do you have them at different times of the day when there are different shifts?

If residents are transported via buses, ambulances or vans, will there be enough to meet their needs? Is there a written document, like a memorandum of understanding or a contract with these transportation providers?

Is there a backup plan if they can’t handle the demand?

Where will residents be taken (other nursing homes, hospitals or to family?) and are these places going to be able to accommodate them?

Do they have a way to transmit medical records along with residents and, if so, how are they going to do it?

How and when will you tell a family member where their loved one has been moved? In other words, what’s your communications plan?

If residents need to stay in place for a couple of days, what kind of supplies do you have (food, water, oxygen, medicine and flashlights) and for how many days? Does the place have a generator? Have they thought about an emergency supply kit geared to each resident?

New York State also has a sheet to better understand evacuation plans.